Cirrhosis at the Ouahigouya Regional Teaching Hospital: Status Report and Diagnostic and Therapeutic Challenges in a Region with Limited Resources

Cirrhosis is a relatively common hepatobiliary pathology in developing countries. It is associated with multiple complications, and its management is often delayed. Objective: The aim of this study was to evaluate the epidemiological, clinical, paraclinical and prognostic aspects of cirrhosis in the hepato-gastroenterology department of the teaching hospital of Ouahigouya. Methodology: this was a cross-sectional observational-analytical study with retrospective data collection, carried out on the inpatient ward at the Ouahigouya’s regional teaching hospital from January 1st, 2021, to December 31st, 2023. Results: 96 cases were collected. The mean age of the patients was 45.72 years old, with a male predominance of 77%. No patient had been vaccinated against hepatitis B virus (HBV). Etiologies of cirrhosis were dominated by HBV (75%), alcohol (7.29%) and hepatitis C virus (HCV) (4.17%). The average admission time was 36 days. The main functional signs on admission were abdominal distension (56.21%) and abdominal pain (51.04%). Ascites (80.21%), pelvic limb edema (66.67%), jaundice (64.58%) and hepatomegaly (45.83%) were the most frequently encountered physical signs. The most frequent biological abnormalities were cholestasis syndrome (82.43%) and hypoalbuminemia (89.83%). Upper GI endoscopy revealed esophageal varices in 88.37% of cases. The clinical course was marked by complications in 51.04% of patients, including hepatocellular carcinoma (73.4%), hepatic encephalopathy (22.4%), hepatorenal syndrome (12.2%), upper GI haemorrhage and ascites fluid infection (10.2%) in each case. In-hospital mortality rate was 43.75%, with hepatocellular carcinoma the main cause. Conclusion: Cirrhosis was discovered late in the decompensation or complication stages in our hospital. HBV is the predominant etiology. The benefits of hepatitis B vaccination have yet to be felt.